Questionnaire Text

Questionnaire form view entire document:  text  image

All Persons
[Applies to questions P1-P10]


P8. Does [respondent] have any problem with his/her eyes, ears, speech, communication, legs, arms or any combination of these impairments?
Encircle code.

[] 1. Yes
[] 2. No. Skip to P10.


P9. What type of disability does [respondent] have?

[] 01. Cannot see with both eyes (TOT-BLIND)
[] 02. Absence of one eye with low vision on the other eye (PART-BLIND)
[] 03. Can see form or movement but not details of objects (color, surface, lines) (LOW VISION)
[] 04. Cannot hear with both ears (TOT-DEAF)
[] 05. Cannot hear with one ear but with moderate hearing loss on the other ear (PART-DEAF 1)
[] 06. Can hear speech but cannot discriminate the words (PART-DEAF 2)
[] 07. Cannot say words (MUTE)
[] 08. Can say words but stammers (includes cleft-palate and hare-lip with speech defect) (SPEECH DEFECT)
[] 09. Loss of one or both arms/hands (NO ARM)
[] 10. Loss of one or both legs/feet (NO LEG)
[] 11. Paralysis of one or both upper extremities (PARA-ARMS)
[] 12. Paralysis of one or both lower extremities (PARA-LEGS)
[] 13. Paralysis of one arm and one leg (PARA-COM)
[] 14. Paralysis of all four limbs (QUADRIP)
[] 15. Can learn simple communication, elementary health and safety habit and simple manual skills, but does not progress in functional reading or arithmetic (REGARDED)
[] 16. Mentally ill (INSANE)
[] 17. Others, specify (includes multiple disabilities and other combination of arm-leg impairment/paralysis) (OTHER)

Questionnaire instructions view entire document:  text  image

Disability (P8 and P9)

To identify household members who may have disabilities, a "screening" question is asked in column P8. For each household member, ask the respondent "Does _________ have any impairment of his/her eyes, ear, speech, communication, legs, arms, or any combination of these?" If the answer is YES, encircle " 1 " in P8 and ask the question in column P9: "What type of disability does ________ have?". If the answer in P8 is NO, encircle "2" and place a dash (--) in P9.

For the POPCEN, the specific types of disabilities and their respective codes are found in the Codes Sheet. Be sure to use this list as your guide in probing for information and for coding the responses in column P9. Descriptions of the disabilities are given below. Use the key words (in bold type capital letters after each type of disability) as the write-in entries.

01 - Cannot see with both eyes. [Refers to a person with total lack of vision of both eyes (totally blind)]. TOT-BLIND

02 - Absence of one eye with low vision in the other eye. [Refer to a person with no vision in one eye whether with or without an eyeball but low vision in the other eye (partially blind).] PART-BLIND

03 - Can see form or movement but not details of objects (color, surface, lines). LOW VISION

04 - Cannot hear with both ears. [Refers to a person with total deafness.]
TOT-DEAF

[p. 93 ]

05 - Cannot hear with one ear but with moderate hearing loss on the other ear. [Refers to a person with one ear totally deaf while the other ear can still react or recognize sounds (partially deaf).] PART-DEAF1

06 - Can hear speech but cannot discriminate the words. [Refers to a person whose both ears can recognize sounds but cannot determine the words (partially deaf).] PART-DEAF2

07 - Cannot say words. [Refers to a person who cannot talk (e.g. mute -- this is because of lack of training on speech development or caused by accident or sickness that damage the vocal cord or tongue.] MUTE

08 - Can say words but stammers (includes cleft-palate and hare-lip with speech defect). SPEECH DEFECT

09 - Loss of one or both arms/hands. [Refers to a person without one or both arms/hands either acquired from birth or amputated as a result of accident or sickness] NO ARM

10 - Loss of one or both legs/feet. [Refers to a person with one or both legs or feet missing, either congenital or amputated as a result of accident or sickness.]
NO LEG

11 - Paralysis of one or both upper extremities. [Refers to a person who cannot use his/her arms and hands either one or both (e.g. stroke victim) and the paralysis is permanent).] PARA-ARMS

12 - Paralysis of one or both lower extremities. [Refers to a person who cannot move either one or both feet and the paralysis is permanent.] PARA-LEGS

13 - Paralysis of one arm and one leg. PARA-COM

14 - Paralysis of all four limbs. [Refers to a person who is a quadriplegic.]
QUADRIP

15 - Can learn simple communication, elementary health and safety habit and simple manual skills, but does not progress in functional reading or arithmetic. [Refers to people with severe mental retardation.] RETARDED

[p. 94]

16 - Mentally insane. [Refers to a person who is suffering from nervous breakdown/mental illness or one who is insane.] INSANE

17 - Others, specify. [Refers to disabilities other than the above, including multiple disabilities and other combination of other arm-leg impairment/paralysis.]
OTHER